Brcic Luka, Kern Izidor
Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria.
Cytology and Pathology Laboratory, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
Transl Lung Cancer Res. 2020 Jun;9(3):924-933. doi: 10.21037/tlcr.2020.03.38.
Malignant mesothelioma (MM) is uncommon, but very aggressive tumor arising from the mesothelial cells of pleura, pericardium, peritoneum, and tunica vaginalis. Despite multimodality treatments 5-year survival is only 5% after the diagnosis. Histology and TNM staging system are still the best prognostic factors. Furthermore, histologic subtype of MM determines the clinical management of the patients. According to the 2015 WHO classification, MM is divided into diffuse, localized and well differentiated papillary mesothelioma. Major histologic subtypes of diffuse MM, namely epithelioid, biphasic and sarcomatoid, have different prognosis. However, in the last decade it has become evident that more detailed subclassification and histologic/cytological characterization of MM have prognostic and perhaps predictive implications. In this review, major histologic subtypes and cytological features of MM are presented and their relation with prognosis and predictive biomarkers is discussed.
恶性间皮瘤（MM）并不常见，但却是一种起源于胸膜、心包膜、腹膜和鞘膜间皮细胞的侵袭性很强的肿瘤。尽管采用了多模式治疗，但诊断后的5年生存率仅为5%。组织学和TNM分期系统仍然是最佳的预后因素。此外，MM的组织学亚型决定了患者的临床管理。根据2015年世界卫生组织的分类，MM分为弥漫性、局限性和高分化乳头状间皮瘤。弥漫性MM的主要组织学亚型，即上皮样、双向性和肉瘤样，具有不同的预后。然而，在过去十年中，越来越明显的是，MM更详细的亚分类以及组织学/细胞学特征具有预后意义，甚至可能具有预测意义。在本综述中，介绍了MM的主要组织学亚型和细胞学特征，并讨论了它们与预后和预测生物标志物的关系。
